NeuroStar vs BrainsWay Deep TMS: Complete Comparison

NeuroStar and BrainsWay are the two most widely encountered TMS systems in the US market. They use fundamentally different coil designs — NeuroStar’s figure-8 coil is precise and focused; BrainsWay’s H-coil reaches deeper structures. Comparing them means understanding what you’re treating, what your insurance covers, and what’s available near you.

What You’ll Learn

• How figure-8 coil (NeuroStar) and H-coil (BrainsWay) designs differ
• FDA clearances for each system
• Efficacy for depression and OCD
• Session experience and scheduling
• Cost and insurance considerations

The Core Difference: Coil Design

NeuroStar uses a proprietary iron-core figure-8 coil that focuses magnetic pulses on a precise, shallow area of the prefrontal cortex (~2cm depth). Think of it like a spotlight — highly targeted, efficient stimulation of a specific region.

BrainsWay uses a patented H-coil design built into a helmet that stimulates wider and deeper brain regions (~4cm depth). Think of it like a floodlight — broader stimulation that reaches subcortical structures more easily.

The depth advantage is most relevant for OCD, where the anterior cingulate cortex — a deeper structure — is a primary treatment target.

FDA Clearances

BrainsWay leads in OCD clearance — it’s the only device with that specific indication. NeuroStar has a unique anxious depression clearance and first-to-market advantage for depression.

Efficacy for Depression

Both devices have strong clinical data:

• NeuroStar: 83% of patients showed improvement in real-world outcomes registry; 62% achieved response
• BrainsWay: 75% response rate in pivotal trials; H-coil may engage reward circuits more effectively

Head-to-head comparisons are limited. Meta-analyses suggest comparable efficacy for standard depression treatment. For OCD, BrainsWay’s specific indication and trial data give it a clear edge.

Session Experience

NeuroStar:

• 19 minutes with theta burst (Express TMS) protocol
• 37 minutes with standard protocol
• Small coil positioned against left forehead
• You can watch TV or listen to music during treatment
• Drive yourself home afterward

BrainsWay:

• 20 minutes per session (deep TMS protocol)
• Helmet-based coil system
• Broader, more diffuse sensation
• Some patients find the helmet initially awkward

Which Should You Choose?

Choose NeuroStar if:

• Your primary diagnosis is depression
• You want the shortest session time (19 min theta burst)
• You want the most widely available option with easiest insurance coverage
• You have anxious depression

Choose BrainsWay if:

• You have OCD — it’s the only FDA-cleared TMS option for OCD
• You want to quit smoking (FDA-cleared for cessation)
• You’ve already tried standard rTMS without adequate response
• Your psychiatrist recommends deeper stimulation

The Bottom Line

Both are effective, FDA-cleared, and insurance-covered. Your provider’s expertise matters more than which machine they own. For OCD specifically, BrainsWay is the clear choice. For depression without OCD, NeuroStar’s wider availability and Express TMS protocol make it the practical first option for most patients.

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